Dr. Elaina George, an Otolaryngologist out of Atlanta, says that the doctor alleged to have killed Michael Jackson was not only unethical, but incredibly irresponsible in his choice of medications. Dr. Conrad Murray is subject to investigation after Jackson’s death was ruled a homicide in initial autopsy reports. But while many believe that Jackson’s death was an accidental occurrence, Dr. George states that the combination of drugs given to Jackson was almost likely to kill him.

“There was no way that harm would not have come to Mr. Jackson,” says Dr. George, who advocates for doctors on a regular basis. “It was beyond negligent to give him a mixture of three different kinds of sedatives, a muscle relaxant, an antidepressant in addition to Propofol, a general anesthetic that is only used in an operating room setting (because it can stop someone’s breathing). Each of these drugs by themselves can be lethal, but together it is a recipe that will almost definitely kill someone.”

Hmmm...maybe that's why Dr. Conrad Murray is being so cooperative with the Los Angeles Police Department. And the Las Vegas Police Department. And the Clark County Sheriff's Department. And the Drug Enforcement Administration.

It seems it's not the good doctor's first time at the rodeo.

A check of Michael Jackson's physician's legal past has revealed everything from domestic violence charges (of which he was acquitted) to financial woes (which at one point included a bankruptcy filing) to his latest headache (you know, other than that whole target-of-a-manslaughter-investigation thing), the possibility that his Las Vegas home could soon be foreclosed upon.

Let's hope the feds treaded lightly during yesterday's search. Depreciation can be a real bitch.

Documents filed July 23 with the Clark County Recorder reveal that Murray could face foreclosure on his gated country club estate as soon as November. Though the timing on the filing may seem a bit like kicking Murray when he's down, Jackson's doctor reportedly fell more than $100,000 into debt on the home, with his last payment, of $15,000, being made in January of this year. (Which may be why Murray was so keen to stay in Jackson's good graces and keep the $150,000-a-month salary that came with it.)

As for Murray's less current troubles, here's a rundown of his legal lowlights:

Friday, August 21, 2009

Dr. Elaina George, a prominent family practice physician in Atlanta, has a bone to pick with President Obama. During various healthcare town hall meetings and press conferences, the president has villified doctors as the cause of the high cost of healthcare. But Dr. George doesn't agree.

As one of the few black doctors in America who is taking the time to speak out in the current healthcare debate, Dr. George says that the culprits in the high cost of healthcare are The American Medical Association, hospitals, big pharmaceutical companies and insurance companies. Here is how she breaks it down.

1) Our country has gotten away from preventing illness and is instead engaged in the high cost of managing disease. Dr. George explains in the interview below that rather than actually curing illnesses or preventing them, we simply try to manage them. Her argument, as with many others in the healthcare profession, is that this attitude is driven by the fact that pharmaceutical and insurance companies only maximize profits when people stay sick. Symptoms tend to be treated instead of the underlying cause of the illness, making problems worse in the long-term.

2) According to some physicians, the public option on healthcare may not be as great as it sounds. When it comes to the public option (which is being heavily debated right now), Dr. George argues that while the option may provide health coverage for many Americans who don't have it, it may not cause insurance companies to pay their fair share of the cost of healthcare reform. "The argument that the public option will drive down costs is disingenuous," says Dr. George. "How can a program designed to cover about 10 million people (as per the Congressional Budget Office) really exert any pressure on the health insurance industry when a company like Blue Cross and Blue Shield has over 30 million members and United Healthcare is even larger?"

Tuesday, August 18, 2009

The debate on healthcare reform is in full swing, but no one is paying attention to the long term effects.

I am for universal healthcare in theory. As a physician, I believe that it is a fundamental right. Unfortunately, the way the debate and pending legislation has been crafted, the outcome will result in unintended consequences.

As a physician in solo practice, I am in a unique position to see the outcome if we continue on the path that Congress is proposing in HR 3200.

A single payer system that pays the same rate as Medicare or as the bill stipulates (5% above Medicare) will lead to LESS choice. People are overlooking the fact that most private physicians are currently NOT accepting new Medicare patients because they can’t afford to do so and stay open. There will be no reason for this to change if the reimbursement scale is adopted.

Unintended consequence: The network of private physicians would be smaller and more patients will be placed in a system of fewer physicians, less choice and longer waiting times to be seen. This would have the opposite effect – what is the point of universal healthcare if you don’t have quality physicians to provide it?

2. The proposed healthcare bill sets up a bureaucracy run by a National health insurance commissioner and sets up an insurance “self regulatory agency” – made up of national insurers, national agencies, and insurance producers. There are no physicians or patient advocates.

With the bombardment of speeches, commentaries and rowdy town forums, many Americans are struggling to decipher the current state of health care reform. Understanding the ins and outs of over 1,600 pages of proposed law is daunting. Unfortunately, there is no politician or any crystal ball that can predict either plan's success at this stage.

To date, two bills have been proposed - the 1,017-page House bill (H.R. 3200) and the 615-page Senate Health Committee bill. A third bipartisan bill is said to be in the works from the Senate Finance Committee. Until September, when Congress reconvenes, we will continue to wait and debate on the limited information we do have.

Here is a summary of those bills, commonly-raised concerns and the debate as it now stands.

1) Problem: The Uninsured Millions are uninsured and falling ill without insurance can be financially catastrophic. Many of these are working people, or recently unemployed, who can't afford to buy insurance plans. Others are self-employed or small business owners who also can't afford insurance. Some are between the ages of 55 (retirement age) and 65 (Medicare-eligible age), and thus have no coverage. In 2008, the Kaiser Commission reported that 41 million were uninsured, while another 35.8 million people had no insurance during part of the year.

Proposed Solution: "Health care for all." Both bills have outlined strategies to include all Americans in some form of a health insurance plan - whether Medicaid, Medicare, the private or the public/community option.

2) Problem: Pre-existing conditions People with any history of medical problems ("pre-existing conditions") can be denied coverage by certain insurance plans because their condition makes them too high-risk.

Proposed Solution: Ban the pre-existing condition clause for all health insurance companies, including those in the private option. The hope is that as more young and healthy Americans have insurance and pay their premiums, that money will offset the costs of taking care of the sicker Americans.

3) Problem: The under insured Some people with health insurance have plans that don't cover all basic health care needs (the "under-insured").